The first step of the melanoma diagnostic process often involves a person noticing changes in their skin. A doctor may then conduct a physical exam, ask about the person’s medical history, and order a biopsy.
Melanoma is a form of skin cancer. Early recognition and diagnosis of the condition may help improve treatment outcomes.
This article explains the diagnostic process for melanoma in more detail, including self-examination, medical history, physical examination, and biopsies. It also explores melanoma treatment and prevention.
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Skin changes to look out for
- new, growing, or changing spots or bumps
- bleeding sores
- sores that do not heal for several weeks
- scaly or rough inflamed patches of skin that may bleed or develop a crust
- growths that look similar to warts
- moles that have changed color, size, or shape
- oddly shaped moles
- moles with irregular borders or different colored patches
One way to do this is through a skin self-examination.
Learn more about how to identify melanoma symptoms.
How to perform a self-examination
The ACS indicates that it may be best to do this after a shower or bath, in front of a well-lit mirror, and with the help of family, partners, or friends for areas that are more difficult to see, such as the scalp or back.
Doctors may recommend that people do this once a month, especially if they have a higher risk of melanoma.
The steps are as follows:
- While facing the mirror, people should check the skin of their face, neck, ears, chest, and abdomen. A person should lift any folds of skin to observe the skin underneath, if necessary.
- Still facing the mirror, they should then check under the arms, both sides of both arms, the palms, the backs of the hands, and under the fingernails.
- Sitting down, a person should check the tops of the thighs, the skins, the tops of both feet, between the toes, and under the toenails.
- While seated, they should use a hand mirror to check the calves, the bottom of the feet, and the backs of the thighs, first on one leg, then the other.
- They should then check the buttocks, lower back, upper back, genitals, and the back of the neck and ears with the hand mirror. People might find it easier to look at their back in a wall mirror.
- A person should part their hair with a hair dryer or comb to check their scalp.
People who notice any suspicious changes should speak with a doctor.
Learn about melanoma on darker skin tones.
A healthcare professional
- when they first appeared
- whether they are itchy, painful, or bleed
- whether they have changed in size or appearance
Learn more about how to tan more safely and minimize the risks.
A doctor who suspects that a particular area might be a melanoma
Types of biopsies for melanoma include:
- Shave biopsy: A dermatologist removes the top layers of skin with a blade. They stop the bleeding using an ointment or a small electrical current that closes off the wound. Doctors typically only request this for people with a low risk of melanoma, as it does not show how deep a melanoma has penetrated.
- Punch biopsy: The doctor uses a tool that works in a similar way to a cookie cutter to remove a deeper skin sample. They rotate the tool until it gets through every layer of skin before removing the sample and stitching the area where they removed the skin back together.
- Incisional and excisional biopsy: A dermatologist uses these types of biopsy to examine melanomas that might have moved to deeper layers. In an excisional biopsy, they use a surgical knife to remove the whole tumor and send it to a lab for testing. During incisional biopsies, they only remove part of the tumor.
If a doctor suspects that the melanoma has spread, they may take a lymph node biopsy. A healthcare professional may also order imaging tests, such as a CT scan, to help identify melanomas that have reached the brain, lungs, or other areas.
Learn about cancer that spreads to lymph nodes.
Often, treatment for melanoma involves surgery to remove the melanoma as well as an area of unaffected skin around the lesion. However, this depends on the location and type of melanoma.
Removal may be the only treatment necessary for early melanoma. However, a dermatologist may find cancer cells in the skin surrounding the melanoma, meaning it has spread. In this case, they may also need to target and kill cancer cells through other methods, including:
- Sheltering in the shade on hot or sunny days.
- Wearing clothes that reduce skin exposure to the sun.
- Using sunscreen on all skin that is not covered by clothing. It should have a sun protection factor (SPF) of 30 or higher.
- Reapplying sunscreen every 2 hours and after sweating or swimming.
- Avoiding tanning beds.
- Taking sun-protection precautions near sand, snow, and water, as these can reflect UV rays.
By conducting a self-examination, people may be able to identify possible melanomas to discuss with a healthcare professional. Doctors typically use a person’s medical history, a physical examination, and biopsies to diagnose melanoma.
Healthcare professionals may recommend a range of treatments for the condition, including surgery, immunotherapy, and chemotherapy.
People can take steps to help prevent melanoma, such as using sunscreen, avoiding tanning beds, and staying in the shade whenever possible on sunny days.